What happens at an ayahuasca ceremony? What anthropologists and researchers have documented

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“Ayahuasca ceremony” sounds like one thing. In the research it is several. Anthropologists have studied healing sessions in Amazonian communities, sociologists and courts have described church services in Brazil and abroad, and health researchers have surveyed the retreats that now host visitors. This page sets out what they documented, where they disagree, and what the risks and the law are in Canada.

Is there one kind of ayahuasca ceremony?

No. A 2023 review lists many names for ayahuasca practitioners, including taita, vegetalista, ayahuasquero, maestro, onaya and curandero, and notes that in certain groups only the healer drank the brew, to diagnose illness and decide on treatment (Ruffell et al., 2023). The same review records a scholarly debate on origins: some propose that today’s ceremonial forms took shape around 300 years ago in a Spanish missionary context and spread through rubber camps, pointing to shared terms, musical structure and the ritual use of tobacco smoke, while allowing that some elements are older. Evidence: established that practices vary; their history is unresolved.

Even the word “ceremony” has a history. The anthropologist Bernd Brabec de Mori, who did fieldwork among the Shipibo-Konibo from 2000 to 2006, writes that the term appeared in the 1990s and has been used for sessions involving visitors, and that communal drinking sessions developed after researchers and tourists arrived (Brabec de Mori, 2021). Evidence: one anthropologist’s account, from long fieldwork.

What happens in Shipibo-Konibo healing sessions?

The Shipibo-Konibo are an Indigenous nation of the Ucayali region of Peru. Writing from 15 years of fieldwork, Favaron, Williams and Bédard argue that Shipibo use of the brew cannot be understood apart from its linguistic, cosmological and spiritual framework, and they warn against reducing it to Western psychology. Their article centres the words of Shipibo visionary healers, the onanyabo (Favaron, Williams and Bédard, 2026). Evidence: established as published scholarship.

The healer and the songs

In Brabec de Mori’s account of healers working in their own communities in the early 2000s, songs were the main means of healing. A healer’s standing rested on long periods of training with plants, relationships with non-human allies, and a large repertoire of songs. He writes that drinking ayahuasca was optional and restricted to the specialist, that patients did not drink it, and that the most powerful healers, the meraya, did not use it at all (Brabec de Mori, 2021). Evidence: established as one fieldworker’s observation.

Icaro is the general name for the medicine songs used by curanderos in the Peruvian Amazon. A 2021 study of a Shipibo-led healing program for Western visitors recorded how the healers described their own work: the first icaro of a ceremony is meant to set up a protective structure around the space, the first ceremony in a series is diagnostic, later ones aim to clear what the healers call dense energies, and a final ceremony seals the work. The healers also used tobacco smoke and, outside ceremonies, plant and flower baths (Gonzalez et al., 2021). Evidence: established as the healers’ own description; these are beliefs, not tested mechanisms.

That program shows how tradition has adapted. Its ceremonies were run by five Shipibo onanyabo with two Western facilitators, and the authors say they were rooted in Shipibo medicine but adapted for Western participants. The authors add that, within this system, separating the brew’s effects from the healers’ work is not even conceived (Gonzalez et al., 2021). Evidence: established as described.

Is purging part of the tradition?

Researchers disagree. Fotiou and Gearin, drawing on the literature and on interviews or surveys with 227 people in Peruvian shamanic tourism and Australian neo-shamanic networks between 2003 and 2015, conclude that purging has been integral to the therapeutic use of ayahuasca across and beyond Amazonia, and argue it should not be dismissed as a mere side effect (Fotiou and Gearin, 2019). The 2023 review notes that some practitioners call the brew “la purga” and that vomiting is traditionally seen as expelling physical toxins and psychological trauma (Ruffell et al., 2023).

Brabec de Mori reports something different from the community setting he studied: in around 100 sessions among traditional Shipibo healers, he saw no healer vomit, and vomiting “was not a topic” (Brabec de Mori, 2021). Both can be true. Purging may matter a great deal in some settings, especially those with visitors drinking, and little in others. Evidence: unresolved as a general claim about “the tradition”.

What happens at Santo Daime and UDV services?

The Brazilian ayahuasca religions run ceremonies as church services. A 2023 review says ayahuasca entered urban Brazil within religious contexts in the 1930s, and that churches such as Santo Daime, Barquinha and the União do Vegetal (UDV) incorporated it (Ruffell et al., 2023). A 2012 study describes members as typically taking part at least twice a month (Bouso et al., 2012). Their founders, beliefs and court cases are covered in Santo Daime and the UDV. Evidence: established.

A 2009 US federal court opinion gives a rare detailed record of one Santo Daime church in Oregon. The court described the church’s spiritual leader as its “padrinho”, and found that hymns constitute church doctrine and are sung at most services, that members were expected to attend three or four times a month at services lasting several hours and sometimes almost all night, and that members learn some Portuguese to understand the hymns. It recorded that members may sit quietly with eyes half-closed, that they view vomiting and diarrhea as a beneficial purging or cleansing, and that the church screened out thrill-seekers and people who might be too physically weak or mentally unstable (Church of the Holy Light of the Queen v. Mukasey, 2009). Evidence: established as the court’s findings about one church.

Settings shape experience. A 2023 study in Uruguay compared one neo-shamanic group with one Santo Daime group, including an ethnographic description of both rituals. The neo-shamanic group scored higher on bodily and perceptual effects, which the authors relate to its “high-arousal ritual setting”, while the Santo Daime group scored lower on several anxiety-related personality measures (Apud et al., 2023). Evidence: preliminary (two small groups).

What happens at retreat-style ceremonies?

Retreats for visitors are the newest form. Brabec de Mori writes that most such sessions are held for non-Indigenous people, run by neo-shamans who either trained with Amazonian practitioners or created their own eclectic styles (Brabec de Mori, 2021). One published description comes from a 2025 study of a four-day retreat with 36 participants: ceremonies began at 9 pm and lasted six hours, with music, guided meditations and interfaith elements, and morning sessions for sharing experiences (Sznitman et al., 2025). Evidence: established for that retreat; formats vary widely.

Safety practice varies too. In 2023 researchers interviewed 49 organizations advertising psychedelic retreats in English, all offering ayahuasca, psilocybin or both. All collected medical histories and 36 (73.5%) excluded people with certain health conditions; 43 (87.8%) required or recommended stopping medications for periods that varied widely; and 34 (69.4%) worked with a licensed health professional or someone with emergency training. The authors found “substantial variability” and said some practices may increase risk, and called for guidelines developed with Indigenous and non-clinical communities (McGuire et al., 2026). Evidence: established for those organizations; self-reported by them.

What concerns do researchers raise about ceremonies?

Physical effects are common. In the Global Ayahuasca Survey of 10,836 people from more than 50 countries, 69.9% reported acute physical adverse effects, mainly vomiting, and 2.3% said they later needed medical attention. Adverse mental health effects in the following weeks or months were reported by 55.9%, though most saw them as part of a positive process; about 12% sought professional support. Taking ayahuasca in a non-supervised context was linked to more physical effects, and religious settings to fewer mental health effects (Bouso et al., 2022). Evidence: preliminary (self-selected, self-reported).

Abuse is a documented concern in psychedelic settings generally. In an anonymous survey of 1,221 people who had used psychedelics, 8% said they or someone they knew had experienced inappropriate sexual contact by a sitter, guide or practitioner (Kruger et al., 2025). The survey covered all psychedelics and settings, not ayahuasca alone. Evidence: preliminary.

Official advice is blunt. Canada’s travel advice for Peru, last updated 15 October 2026, says ceremonies offered by shamans and others have led to serious illness, injury, assault and even the death of several tourists, often take place far from medical care, are not regulated, and advises Canadians to avoid them (Government of Canada, travel advice for Peru). The advisory gives no count of cases. Evidence: established for what the advisory says.

Anthropologists add a cultural critique. Fotiou, from fieldwork around Iquitos, argues that Western engagement often rests on romanticised ideas of Indigenous shamanism, and that this is “not benign”: it hides the injustices Indigenous people face, including the commercialisation of their spirituality (Fotiou, 2016). Brabec de Mori calls for the “deep coloniality” in the appropriation of Indigenous practice to be questioned in any use of ayahuasca (Brabec de Mori, 2021). Evidence: established as published positions.

Are ayahuasca ceremonies legal in Canada?

As a rule, no. DMT and harmaline, two of the brew’s constituents, are items 7 and 9 of Schedule III of the Controlled Drugs and Substances Act. Section 56(1) lets the Minister of Health exempt a person, a class of persons or a substance if the exemption is necessary for a medical or scientific purpose or is otherwise in the public interest (Justice Laws, CDSA). The consolidation we read on 24 October 2026 was current to 30 September 2026. Evidence: established.

Religious exemptions have reportedly been granted. The founder of a Montreal Santo Daime church wrote that, after working with Health Canada since 2001 and a refusal in 2012, the church received a section 56 exemption in June 2017 (Chacruna, 2017). In 2019, CTV News reported five exemptions for religious groups in Quebec and Ontario, granted in 2017 and 2018, each valid for two years and renewable, with a Health Canada spokesperson saying details are confidential (CTV News, 2019). We found no official list of which are in force today. An exemption covers the group named in it, not anyone else. This is general information, not legal advice. For more, see is DMT legal in Canada?. Evidence: preliminary.

What we still don’t know

• How common each ceremony format is; no study counts ceremonies or attendees across traditions (unresolved).
• How much of the reported benefit or harm comes from the brew, the music, the leader or the group; ceremonial studies are naturalistic and rarely have control groups (unresolved).
• How purging is understood across Amazonian groups, since fieldworkers report different things (unresolved).
• How often abuse and serious medical incidents happen in ceremonies specifically (unresolved).
• Which Canadian religious exemptions are in force and on what terms (unresolved).

The fair summary: an ayahuasca ceremony is not one ritual but a family of practices, from a healer singing for a patient to a church singing hymns to a group of visitors at a retreat. For the brew itself, see what is ayahuasca; for what people report feeling, see what does ayahuasca feel like; and for how it differs from DMT alone, see ayahuasca vs DMT.

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